Çocuklarda Akut Lenfoblastik Lösemi Tedavisinin Erken ve Geç Yan Etkileri

Akut lenfoblastik lösemi (ALL) çocukluk çağı kanserleri içinde en sık görülenidir ve tüm çocukluk çağı kanserlerinin %30’unu oluşturur. 1980’lerden bu yana ALL’de sağkalım oranları belirgin şekilde artmış, beş yıllık genel sağkalım oranları %80’nin üzerine çıkmıştır. Sağkalımdaki en büyük başarı standardize edilmiş tedavi protokolleri ile ilişkilidir. Sağkalım oranlarındaki bu başarı oranları ile birlikte hastalığın seyri ve tedavi protokollerinin ağır olması, erken ve geç dönemde tedavi ilişkili ciddi yan etkileri de beraberinde getirmektedir. Bu yan etkilerin çoğu tedavinin ilk bir yılı içinde, indüksiyon döneminde veya hemen sonrasında ortaya çıkmaktadır. Birçok hastada geç dönemde de kanserin kendisine veya tedavisine bağlı kronik fiziksel ve psikolojik problemler de tespit edilebilmektedir. Bu derlemenin amacı ALL tedavisine bağlı erken ve geç dönemde ortaya çıkabilecek yan etkilerin gözden geçirilmesidir.

Anahtar Kelimeler:

Akut lenfoblastik lösemi, Tedavi, Yan etkil

Early and Late Side Effects of Acute Lymphoblastic Leukemia Therapy in Children

Acute lymphoblastic leukemia (ALL) is the most common form of cancer in children, comprising approximately 30 percent of all childhood malignancies. Survival rates for ALL have improved dramatically since the 1980s, with current fi ve-year overall survival rates estimated at greater than 80 percent. This improvement in survival is due to treatment of a large number of children on sequential standardized research protocols. While the vast majority of children with ALL enjoy long-term survival/cure, the serious nature of the disease, as well as the aggressiveness of the treatment protocols have resulted in signifi cant early and late treatment-related mortality. Much of the treatment-related mortality occurs during the fi rst year of ALL treatment, often during induction or shortly thereafter. Many long-term survivors of childhood cancer will also develop chronic physical or psychosocial problems as a result of their cancer or its therapy. The purpose of this paper is to review the early and late effects of ALL therapy

Keywords:

Acute lymphoblastic leukemia, Treatment, Side effect,

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